PDF(Pubmed)
Abstract：
UNASSIGNED: The diagnosis and prognostication of chronic kidney disease (CKD) largely rely on glomerular measures that may not reflect tubular damage. We investigated the associations of urine kidney tubule biomarkers with estimated glomerular filtration rate (eGFR) change among middle-aged adults, when chronic diseases typically emerge.
UNASSIGNED: An observational cohort study.
UNASSIGNED: A total of 1,145 participants of the Coronary Artery Risk Development in Young Adults (CARDIA) study without CKD, hypertension, or cardiovascular disease at the year 20 visit.
UNASSIGNED: Seven different biomarkers of tubular health: urine epidermal growth factor (EGF), alpha-1-microglobulin (α1m), interleukin-18, kidney injury molecule-1, monocyte chemoattractant protein-1, uromodulin, and chitinase-3-like protein 1.
UNASSIGNED: Ten-year eGFR change and incident reduced eGFR (new onset of eGFR < 60 mL/min/1.73 m2).
UNASSIGNED: We examined associations of tubular health biomarkers with 10-year eGFR change and incident reduced eGFR with linear mixed models and interval-censored proportional hazards regression models, respectively. Both minimally and fully adjusted models were controlled for urine creatinine levels.
UNASSIGNED: The mean age of participants was 44.8 ± 3.7 years, with 39% African American and 56% female. The average 10-year change in eGFR was -18.6 mL/min/1.73 m2 (95% CI, -19.4 to -17.8). In contrast to the other tubular biomarkers, which showed conflicting results, EGF demonstrated strong, consistent associations with both kidney outcomes. Each 1-standard deviation (SD) higher EGF was associated with a 2.37 mL/min/1.73 m2 (95% CI, 0.64-4.10) smaller 10-year decrease in eGFR and a 42% (95% CI, 4%-64%) lower risk of incident reduced eGFR in the fully adjusted model.
UNASSIGNED: Observational design, measurements of eGFR were done only at 5-year intervals during follow-up.
UNASSIGNED: In middle-aged, community-dwelling adults without hypertension, cardiovascular disease or CKD, higher urine EGF concentrations are associated with slower eGFR decline, whereas other kidney tubule biomarkers lacked a consistent association with kidney function decline.
Current measures of chronic kidney disease (CKD) rely on markers of glomerular health and function. This approach inadequately captures the role of kidney tubule health, a known histopathological predictor of CKD development. We investigated associations of 7 biomarkers of kidney tubule health with 10-year estimated glomerular filtration rate (eGFR) change and incident reduced eGFR. Among 7 biomarkers, only epidermal growth factor showed persistent and inverse associations with both 10-year eGFR change and incident reduced eGFR. These findings suggest that epidermal growth factor has an association with kidney function changes and might play a protective role in kidney disease development.
UNASSIGNED: An observational cohort study.
UNASSIGNED: A total of 1,145 participants of the Coronary Artery Risk Development in Young Adults (CARDIA) study without CKD, hypertension, or cardiovascular disease at the year 20 visit.
UNASSIGNED: Seven different biomarkers of tubular health: urine epidermal growth factor (EGF), alpha-1-microglobulin (α1m), interleukin-18, kidney injury molecule-1, monocyte chemoattractant protein-1, uromodulin, and chitinase-3-like protein 1.
UNASSIGNED: Ten-year eGFR change and incident reduced eGFR (new onset of eGFR < 60 mL/min/1.73 m2).
UNASSIGNED: We examined associations of tubular health biomarkers with 10-year eGFR change and incident reduced eGFR with linear mixed models and interval-censored proportional hazards regression models, respectively. Both minimally and fully adjusted models were controlled for urine creatinine levels.
UNASSIGNED: The mean age of participants was 44.8 ± 3.7 years, with 39% African American and 56% female. The average 10-year change in eGFR was -18.6 mL/min/1.73 m2 (95% CI, -19.4 to -17.8). In contrast to the other tubular biomarkers, which showed conflicting results, EGF demonstrated strong, consistent associations with both kidney outcomes. Each 1-standard deviation (SD) higher EGF was associated with a 2.37 mL/min/1.73 m2 (95% CI, 0.64-4.10) smaller 10-year decrease in eGFR and a 42% (95% CI, 4%-64%) lower risk of incident reduced eGFR in the fully adjusted model.
UNASSIGNED: Observational design, measurements of eGFR were done only at 5-year intervals during follow-up.
UNASSIGNED: In middle-aged, community-dwelling adults without hypertension, cardiovascular disease or CKD, higher urine EGF concentrations are associated with slower eGFR decline, whereas other kidney tubule biomarkers lacked a consistent association with kidney function decline.
Current measures of chronic kidney disease (CKD) rely on markers of glomerular health and function. This approach inadequately captures the role of kidney tubule health, a known histopathological predictor of CKD development. We investigated associations of 7 biomarkers of kidney tubule health with 10-year estimated glomerular filtration rate (eGFR) change and incident reduced eGFR. Among 7 biomarkers, only epidermal growth factor showed persistent and inverse associations with both 10-year eGFR change and incident reduced eGFR. These findings suggest that epidermal growth factor has an association with kidney function changes and might play a protective role in kidney disease development.
摘要：
■慢性肾脏病（CKD）的诊断和预后在很大程度上依赖于可能无法反映肾小管损伤的肾小球测量。我们调查了中年人尿肾小管生物标志物与估计的肾小球滤过率（eGFR）变化之间的关联。当慢性病通常出现时。
■一项观察性队列研究。
■共有1,145名没有CKD的年轻人冠状动脉风险发展（CARDIA）研究参与者，高血压,或心血管疾病在20年访问。
■肾小管健康的七种不同生物标志物：尿液表皮生长因子（EGF），α-1-微球蛋白(α1m),白细胞介素-18,肾损伤分子-1,单核细胞趋化蛋白-1,尿调蛋白,和几丁质酶-3-样蛋白1.
■十年eGFR变化和事件降低了eGFR（新出现的eGFR<60mL/min/1.73m2）。
■我们使用线性混合模型和间隔删失比例风险回归模型研究了肾小管健康生物标志物与10年eGFR变化和事件降低eGFR的关联，分别。最小和完全调整的模型均控制尿肌酐水平。
■参与者的平均年龄为44.8±3.7岁，39%的非洲裔美国人和56%的女性。eGFR的平均10年变化为-18.6mL/min/1.73m2（95％CI，-19.4至-17.8）。与其他肾小管生物标志物相比，显示出相互矛盾的结果，EGF表现得很强，与两个肾脏结局一致的关联。在完全调整的模型中，每提高1-标准差（SD）的EGF与eGFR10年下降2.37mL/min/1.73m2（95％CI，0.64-4.10）和事件风险降低42％（95％CI，4％-64％）的eGFR降低相关。
■观察性设计，在随访期间,eGFR的测量间隔仅为5年.
■在中年人，社区居住的成年人没有高血压，心血管疾病或CKD，较高的尿液EGF浓度与较慢的eGFR下降有关，而其他肾小管生物标志物与肾功能下降缺乏一致关联.
目前慢性肾脏病(CKD)的测量依赖于肾小球健康和功能的标志物。这种方法不能充分抓住肾小管健康的作用，CKD发展的已知组织病理学预测因子。我们调查了肾小管健康的7种生物标志物与10年估计的肾小球滤过率（eGFR）变化和事件降低的eGFR的关联。在7种生物标志物中，只有表皮生长因子显示与10年eGFR变化和事件性eGFR降低的持续性和负相关.这些发现表明，表皮生长因子与肾功能变化有关，可能在肾脏疾病的发展中起保护作用。
■一项观察性队列研究。
■共有1,145名没有CKD的年轻人冠状动脉风险发展（CARDIA）研究参与者，高血压,或心血管疾病在20年访问。
■肾小管健康的七种不同生物标志物：尿液表皮生长因子（EGF），α-1-微球蛋白(α1m),白细胞介素-18,肾损伤分子-1,单核细胞趋化蛋白-1,尿调蛋白,和几丁质酶-3-样蛋白1.
■十年eGFR变化和事件降低了eGFR（新出现的eGFR<60mL/min/1.73m2）。
■我们使用线性混合模型和间隔删失比例风险回归模型研究了肾小管健康生物标志物与10年eGFR变化和事件降低eGFR的关联，分别。最小和完全调整的模型均控制尿肌酐水平。
■参与者的平均年龄为44.8±3.7岁，39%的非洲裔美国人和56%的女性。eGFR的平均10年变化为-18.6mL/min/1.73m2（95％CI，-19.4至-17.8）。与其他肾小管生物标志物相比，显示出相互矛盾的结果，EGF表现得很强，与两个肾脏结局一致的关联。在完全调整的模型中，每提高1-标准差（SD）的EGF与eGFR10年下降2.37mL/min/1.73m2（95％CI，0.64-4.10）和事件风险降低42％（95％CI，4％-64％）的eGFR降低相关。
■观察性设计，在随访期间,eGFR的测量间隔仅为5年.
■在中年人，社区居住的成年人没有高血压，心血管疾病或CKD，较高的尿液EGF浓度与较慢的eGFR下降有关，而其他肾小管生物标志物与肾功能下降缺乏一致关联.
目前慢性肾脏病(CKD)的测量依赖于肾小球健康和功能的标志物。这种方法不能充分抓住肾小管健康的作用，CKD发展的已知组织病理学预测因子。我们调查了肾小管健康的7种生物标志物与10年估计的肾小球滤过率（eGFR）变化和事件降低的eGFR的关联。在7种生物标志物中，只有表皮生长因子显示与10年eGFR变化和事件性eGFR降低的持续性和负相关.这些发现表明，表皮生长因子与肾功能变化有关，可能在肾脏疾病的发展中起保护作用。
